title: Association between acute statin therapy, survival, and improved functional outcome after ischemic stroke: the North Dublin Population Stroke Study.
abstract: OBJECTIVE
  Statins improve infarct volume and neurological outcome in animal stroke models. We investigated the relationship between statin therapy and ischemic stroke outcome in the North Dublin Population Stroke Study.
  
  
  METHODS
  A population-based prospective cohort study was performed using rigorous ascertainment methods. Prestroke and acute (≤72 hours) poststroke medications were recorded. Modified Rankin score and fatality were assessed at 7, 28, and 90 days and 1 year.
  
  
  RESULTS
  Of 448 ischemic stroke patients, statins were prescribed before stroke onset in 30.1% (134/445) and were begun acutely (≤72 hours) in an additional 42.5% (189/445). On logistic regression analysis, adjusting for age, prestroke disability (modified Rankin scale), NIHSS score, hypertension, and aspirin, new poststroke statin therapy was independently associated with improved early and late survival (compared with statin untreated patients: OR for death, 0.12; CI, 0.03-0.54 at 7 days; OR, 0.19; CI, 0.07-0.48 at 90 days; OR, 0.26; CI, 0.12-0.55 at 1 year; P≤0.006 for all). Similar findings were observed for statin therapy before stroke onset (adjusted OR for death compared with statin-untreated-patients, 0.04; CI, 0.00-0.33; P=0.003 at 7 days; OR, 0.23; CI, 0.09-0.58; P=0.002 at 90 days; OR, 0.48; CI, 0.23-1.01; P=0.05 at 1 year).
  
  
  CONCLUSIONS
  Statin therapy at stroke onset and newly begun statins were associated with improved early and late outcomes, supporting data from experimental studies. Randomized trials of statin therapy for treatment of acute stroke are needed.
authors.affiliation: Neurovascular Clinical Science Unit, Catherine McCauley Research Centre, Mater University Hospital, Nelson Street, Dublin 7, Ireland. dmmnic@umail.ucc.ie
authors.forename: Danielle
authors.initials: D
authors.lastname: Ní Chróinín
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Callaly
authors.forename: Joseph
authors.initials: J
authors.lastname: Duggan
authors.forename: Áine
authors.initials: Á
authors.lastname: Merwick
authors.forename: Niamh
authors.initials: N
authors.lastname: Hannon
authors.forename: Órla
authors.initials: Ó
authors.lastname: Sheehan
authors.forename: Michael
authors.initials: M
authors.lastname: Marnane
authors.forename: Gillian
authors.initials: G
authors.lastname: Horgan
authors.forename: Emma B
authors.initials: EB
authors.lastname: Williams
authors.forename: Dawn
authors.initials: D
authors.lastname: Harris
authors.forename: Lorraine
authors.initials: L
authors.lastname: Kyne
authors.forename: Patricia M E
authors.initials: PM
authors.lastname: McCormack
authors.forename: Joan
authors.initials: J
authors.lastname: Moroney
authors.forename: Tim
authors.initials: T
authors.lastname: Grant
authors.forename: David
authors.initials: D
authors.lastname: Williams
authors.forename: Leslie
authors.initials: L
authors.lastname: Daly
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Kelly
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000188:drug therapy* / Q000401:mortality* / Q000503:physiopathology; D002784:Cholesterol / Q000378:metabolism; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function / Q000187:drug effects / Q000502:physiology; D020521:Stroke / Q000188:drug therapy* / Q000401:mortality* / Q000503:physiopathology; D015996:Survival Rate / Q000639:trends; D013995:Time
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol